Sarode GS, Sarode SC, Patil S. Multifaceted Role of Calcium in Cancer. J Contemp Dent Pract 2017;18(1):1-2.

To verify the influence of age on factors associated with peri-implant bone loss after prosthetic rehabilitation over osseointegrated implants.

This is an analytical, observational, and longitudinal study with initial 23 participants. Patients presenting with osseointegrated implants with their respective prostheses installed were included, and they could be carriers of chronic and degenerative diseases, such as diabetes, osteoporosis, hypothyroidism, cardiovascular disease (CVD), and systemic arterial hypertension. Thus, 18 participants with 57 implants were selected and followed up from 2009 to 2013. For statistical analysis, chi-square or Fisher's exact test was used for the association of systemic conditions and bone loss. Student's t-test was used for mean comparisons of age and number of total upper and lower implants.

The average age of the sample studied was 71.05 years (65–80). The average implant per person was 3.2. Smoking had an influence on both mesial and distal bone loss, and the latter was significant (p = 0.0370). The association between bone loss and gender was also significant (p < 0.05). Moreover, male gender and upper implants were factors significantly associated with bone loss. The systemic conditions, when isolated, did not have significant influence on implant survival.

Age is not a factor that, alone, contraindicates implant-rehabilitating therapy. On the contrary, smoking has a significant influence on dental implant survival. Systemic diseases, such as osteoporosis, hypothyroidism, diabetes, hypertension, and heart diseases, when controlled, are not contraindication factors.

This study is relevant for assessing peri-implant bone loss in elderly patients, right after implant installation and over time. Therefore, it was possible to verify that age is not a limiting factor for this procedure. Controlled systemic diseases do not contraindicate implant installation, but smoking is a factor that affects implant survival.

Pedro REL, De Carli JP, Linden MSS, Lima IFP, Paranhos LR, Costa MD, Bós ÂJG. Influence of Age on Factors associated with Peri-implant Bone Loss after Prosthetic Rehabilitation over Osseointegrated Implants. J Contemp Dent Pract 2017;18(1):3-10.

The present study was undertaken to evaluate the anatomy of the maxillary sinus in relation to its position and the height of its septa, using cone beam computed tomography (CBCT).

In this descriptive retrospective study, 300 CBCT images of maxillary sinuses of patients with posterior maxillary edentulism were evaluated. The maxillary sinus septa were evaluated in relation to their prevalence, height, and position; t-test and Mann–Whitney tests were used for the analysis of data.

Sinus septa were detected in 44% of the subjects, with equal frequencies in the anterior, middle, and posterior positions. The mean height of the septa was 3.6 ± 1.56 mm.

In a population of Iranian subjects, in half of the cases, the sinus septa might be present in the anterior, middle, and posterior positions.

In order to avoid intraoperative problems during sinus lift procedures, it is necessary to accurately evaluate the sinus, preferably with the use of CBCT.

Taleghani F, Tehranchi M, Shahab S, Zohri Z. Prevalence, Location, and Size of Maxillary Sinus Septa: Computed Tomography Scan Analysis. J Contemp Dent Pract 2017;18(1):11-15.

The purpose of this study was to evaluate whether the open apex measurements of the lower teeth can be used for prediction of the pubertal growth spurt.

The study group consisted of 150 males and 142 females ranging in age from 10 to 16 years. A total of 292 panoramic and 292 hand-wrist radiographs were obtained and analyzed. The skeletal maturity was determined according to the skeletal maturity indicators (SMIs) developed by Fishman. The open apices measurements of the left lower teeth were made according to the method described by Cameriere.

The Spearman rank order correlation coefficient revealed a relationship between the skeletal maturity stages and the open apex measurements. These correlations ranged from 0.577 for the lower second premolar to 0.830 for the lower canine. The measurement of the left lower canine showed the highest correlation, so its relationship with the SMIs was further investigated. The measurements of 6.07 (or greater) indicated to SMI4, and 2.485 (or lesser) indicated to SMI7.

The skeletal maturity well related to the measurements of the open apices of the lower teeth. Lower canine open apex measurements could be used as an indicator of the SMI4 and SMI7.

The measurements of the open apices of the left lower canines from panoramic radiographs may be clinically useful as an indicator of the beginning and the ending of the pubertal growth period.

Issa YN, Burhan AS, Nawaya FR, Massouh LG. Assessment of the Pubertal Growth Period using the Open Apices of the Lower Teeth. J Contemp Dent Pract 2017;18(1):16-22.

The aim of this study was to assess the prevalence and severity of temporomandibular joint disorders (TMDs) among undergraduate medical students in the presence of khat chewing over a period of time.

Totally, 186 medical college students (age ≤ 20 years) were randomly selected for the present study. The study subjects were divided into two groups according to age, under 20 and above 20 years. The study was based on Fonseca's anamnestic index and its questionnaire, which is composed of 10 questions and classifies the severity of TMDs. The obtained data were coded and entered into Statistical Package for the Social Sciences (SPSS) program for analysis using chi-square test at significance level of 5%.

Most of the participants were male (68.8%) students and older than 20 years (63%). Those who reported with khat chewing comprised 31.7%. From the total samples, only 38.0% was classified as having mild TMD and 0.50% were classified as having severe TMD. Poor dental articulation, grinding of teeth, headaches, tense personalities, and temporomandibular joint (TMJ) clicking were the most common clinical findings. The mean scores showed no significant difference among gender (p ≤ 0.29) and the khat chewing (p ≤ 0.531) groups for the 10 questions. However, it showed significant difference among age groups (p ≤ 0.025).

The majority of subjects complained of mild TMD, while only a few cases showed a moderate TMD among different age groups. The most frequently reported dysfunctions were related to poor dental articulation and grinding of the teeth, frequent headaches, the clicking of joint, and tense personalities. No significant difference was found between gender and khat and nonkhat chewing groups.

Khat chewing is a parafunctional habit and affects dental occlusion (especially cuspal wear) in terms of anterior guidance. Such alterations in occlusion are known to be one of the causative (predisposing) factors of TMD.

Al Moaleem MM, Okshah AS, Al-Shahrani AA, Alshadidi AAF, Shaabi FI, Mobark AH, Mattoo KA. Prevalence and Severity of Temporomandibular Disorders among Undergraduate Medical Students in Association with Khat Chewing. J Contemp Dent Pract 2017;18(1):23-28.

Dental caries and obesity are two of the most prevalent health conditions affecting children. Relative decrease in corporeal movements, escalating inactive lifestyles, and changes in dietary factors are strongly linked with the increasing incidence of overweight and obesity. Furthermore, obesity increases the risk of chronic disease and dental caries that significantly affects the quality of life of young children. The present study intends to explore the relationship between dental caries and obesity in children in Al-Kharj city, Kingdom of Saudi Arabia.

The present descriptive study was designed as a cross-sectional study in which a total of 386 children in the age range of 6 to 12 years from elementary schools of Al-Kharj city and pediatric dental clinics in Prince Sattam Dental College were included.

Mean decayed filled teeth (DFT) score was found to be considerably higher among obese children. Also, incidence of dental caries in deciduous dentition was found to be notably higher among obese children.

Obesity has a considerable outcome on prevalence of dental caries among primary schoolchildren in Al-Kharj city, Kingdom of Saudi Arabia. The importance of obesity is limited not only to systemic disorders but also in relation to carious lesions. Hence, educating primary schoolchildren about caries and its related factors is very important.

High intake of free sugar is a wellestablished risk factor for dental caries and also for obesity. Therefore, it is speculated that factors that decrease these risk factors have the potential to affect both conditions at the population level to control it competently.

Abu El Qomsan MAS, Alasqah MN, Alqahtani FA, Alobaydaa MAA, Alharbi MM, Kola Z. Intricate Evaluation of Association between Dental Caries and Obesity among the Children in Al-Kharj City (Saudi Arabia). J Contemp Dent Pract 2017;18(1):29-33.

One of the possible mechanisms for the gradual destruction of bond strength in dentin-resin interface, could be due to the demineralized unstable collagen matrix. Use of protease inhibitors, such as tannic acid (TA) could prevent destruction of collagen fibers. The aim of this study was to compare the TA effect on bond strength of etch and rinse and self-etch adhesive systems in the dentin of primary teeth.

This in vitro study was done on 40 extracted primary molar teeth. The teeth were sectioned in the mesiodistal direction, and enamel of buccal and lingual surfaces was removed. Samples were randomly divided into four groups: Single bond (SB) + TA, SB, Clearfil SE Bond (CSB) + TA, and CSB. Then, Z250 and Clearfil AP-X composites were cured on the surfaces of SB and CSB groups respectively. After that, all samples were divided into aging and non-aging groups. For 3 months, samples were placed under 1,000 thermal cycles in aging group. Subsequently, the shear bond strengths of all groups were measured by the International testing machine, and failure mode was evaluated by an optical stereomicroscope. Data were analyzed with paired t-test and independent t-test.

Tannic acid induced a significant reduction in the immediate bond strength of adhesive SB. Meanwhile, TA had no significant effect on shear bond strength of the CSB system.

Based on our findings, use of TA is not recommended with SB and CSB adhesives on primary teeth.

Tannic acid may not be considered in resin restorations of primary teeth.

Ebrahimi M, Sarraf Shirazi A, Abdolhoseinpour F, Abdollahi M. Effect of Tannic Acid on Bond Strength of Etch and Rinse and Self-etch Adhesive Systems in Dentin of Primary Teeth. J Contemp Dent Pract 2017;18(1):34-38.

The aim of this study was to assess the wear resistance of four bulk-fill composite resin restorative materials cured using high- and low-intensity lights.

Twenty-four samples were prepared from each composite resin material (Tetric N-Ceram, SonicFill, Smart Dentin Replacement, Filtek Bulk-Fill) resulting in a total of 96 samples; they were placed into a mold in a single increment. All of the 96 samples were cured using the Bluephase N light curing unit for 20 seconds. Half of the total specimens (n = 48) were light cured using high-intensity output (1,200 mW/cm²), while the remaining half (n = 48) were light cured using low-intensity output (650 mW/cm²). Wear was analyzed by a three-dimensional (3D) noncontact optical profilometer (Contour GT-I, Bruker, Germany). Mean and standard deviation (SD) of surface loss (depth) after 120,000 cycles for each test material was calculated and analyzed using one-way analysis of variance (ANOVA) with a significance level at p < 0.05.

The least mean surface loss was observed for SonicFill (186.52 µm) cured using low-intensity light. No significant difference in the mean surface loss was observed when comparing the four tested materials with each other without taking the curing light intensity into consideration (p = 0.352). A significant difference in the mean surface loss was observed between SonicFill cured using high-intensity light compared with that cured using low-intensity light (p < 0.001).

A higher curing light intensity (1,200 mW/cm²) had no positive influence on the wear resistance of the four bulk-fill composite resin restorative materials tested compared with lower curing light intensity (650 mW/cm²). Furthermore, SonicFill cured using low-intensity light was the most wearresistant material tested, whereas Tetric N-Ceram cured using high-intensity light was the least wear resistant.

The wear resistance was better with the newly introduced bulk-fill composite resins under low-intensity light curing.

Alkhudhairy F. Wear Resistance of Bulk-fill Composite Resin Restorative Materials Polymerized under different Curing Intensities. J Contemp Dent Pract 2017;18(1):39-43.

Apical periodontitis usually results from bacterial accumulation and contamination occurring in the root-canal system, and extending beyond the apical foramen to involve the periapical tissues. Literature has a paucity of the studies that stress on the division and analysis of the pulp canal segments. The reason for this disparity might be the technique used for collecting the samples from the pulp canals. Hence, we carried out the present study to evaluate the microbial flora in the apical part of the roots with necrotic pulp canals.

The present study included the assessment of 40 freshly extracted teeth that had necrotized pulpal tissue along with the presence of periapical periodontal lesions. Removal of the soft tissue lesions attached to the root portion of the teeth along with apical periodontal lesions was done with the help of scalpel blade, after rinsing them with a sterile solution of saline. Thorough cleaning of the root surfaces was done with hydrogen peroxide followed by rapid disinfection with the help of sodium hypochlorite at varying concentrations. Sectioning of the root portion of all the specimens with the help of a disk was done perpendicular to the long axis of the teeth at a distance of roughly 5 to 6 mm from the teeth's apicalmost point. Cryotubes were used for transferring the specimens of apical portions containing 1 mL of buffer and were subjected to immediate frozen processing at a temperature of –20°C. A 10 K-type file was used for the initial collection of the samples followed by subsequent incubation of the files and paper pints in the incubation cabinet. Subsequent deoxyribonucleic acid (DNA) extraction from the samples was done following the procedure described by Siqueira et al. Paster et al's modification of the reverse-capture checkerboard assay was used in the present study. Semiquantitative data were used for overcoming the difficulties arising due to obtaining the counts of the polymerase chain reaction (PCR)-based analysis of specimens.

A positive result for the 16S ribosomal ribonucleic acid (rRNA) gene primer was observed only in two examined specimens of all the samples of the apical portion of the root canals in the present study. Negative result was shown by all the control group specimens, which were sterile samples. Presence of bacteria was confirmed by PCR in 38 out of 40 examined specimens. Amount of bacterial taxa, out of these 24 samples, ranged up to 6. Pseudoramibacter alactolyticus, Porphyromonas endodontalis, Dialister oral species, Bacteroidetes species, Streptococcus species, Olsenella uli, Synergistes species, Fusobacterium nucleatum, Parvimonas micra, Treponema denticola, and Filifactor alocis were the specific species detected. Bacteroidetes species was the only species that were detected at levels at or above 10⁵. Heavy bacterial infections were noticed in more than 45% of the cases at the periradicular part of the root canals.

Microbial flora of the apical segment of the root with necrotized pulp tissue comprises a vast variety of pathogenic bacteria.

For better prognosis of the treatment of such cases, adequate knowledge of the microbial flora of the root, especially the apical portion is necessary.

Tatikonda A, Sudheep N, Biswas KP, Gowtham K, Pujari S, Singh P. Evaluation of Bacteriological Profile in the Apical Root Segment of the Patients with Primary Apical Periodontitis. J Contemp Dent Pract 2017;18(1):44-48.

Implant-supported prosthesis has high predictability and success and improves quality of life. This study aims at assessing awareness among the patients regarding implantsupported prosthesis.

A cross-sectional study was conducted among 391 study participants. A structured questionnaire was distributed to assess implant-related awareness among the study participants. The questionnaires were analyzed for the responses.

Among the 391 respondents, 37.5% of the respondents reported having moderate knowledge regarding the tooth replacement options. Nearly 50% considered implants as a viable treatment option. The majority of them enlisted the dentist as the major source of information regarding implants, and media had a share of about 7.03% only. High cost was a major barrier in selecting implants as a treatment option.

This survey showed that awareness among people was low regarding the dental implants. Efforts need to be directed to increase the awareness levels by utilizing media as a tool to achieve the target.

A patient who is aware of the advantages of the implant-supported dentures will make an informed decision for better functional stability and retention of the denture, especially in the mandibular arch.

Raju CM, Gunupati S, Babu MM, Reddy CSK, Biradavolu S, Saravanan M. Patients’ Awareness toward Implant-supported Prosthesis: An Observational Study. J Contemp Dent Pract 2017;18(1):49-51.

This research analyzed the influence of television on the behavior of children belonging to urban and rural socioeconomic backgrounds of Bhopal city and its vicinity.

About 400 parents with children between 1 and 18 years of age were subjected to a self-designed questionnaire, which sought information regarding the television viewing habits of children. Differences in responses were noted between the subjects of urban and rural areas. Obtained data were subjected to statistical analysis using Pearson's chi-square test to determine the level of significance.

The urban class showed a dominating pattern in the positive aspects of television viewing, such as significantly better awareness of oral health, more emphasis shown toward oral care adverts, and a higher knowledge of the cause of dental caries. However, the urban class also possessed a poor attitude; the appearance of a dentist on television did not remind them about oral needs, products with gifts pleased their children to a greater extent, they had more demanding children, parents fulfilled their children's demand more, and they relied on the self for selection of toothpaste. Overall, in all aspects, the rural class lacked significantly.

Television exerts a positive as well as negative influence on children's behavior among urban and rural communities, with the influence being more obvious in the urban class.

The results of this study can be utilized in bringing about better and effective advertising oriented toward attaining optimum oral health of children; overall general health through adverts that discourage obesogenic diet and promote a diet rich in protein and fiber can also be focused on.

Bahuguna R, Jain A, Suryavanshi D, Chauhan H, Khan SA, Thakur R. Influence of Television Advertising on Behavior of Children across Socioeconomic Backgrounds. J Contemp Dent Pract 2017;18(1):52-56.

In maxillofacial surgery, the simplest procedure that we perform is dental extraction. However, this simple procedure is challenged by the patient's poor medical condition. We generally use local anesthesia in combination with adrenaline; however, as we come across patients with diabetes mellitus and cardiovascular diseases who seek dental extraction, we need to be doubly cautious while using adrenaline. In this study, we intend to compare the effects of local anesthesia with adrenaline and local anesthesia without adrenaline on hemodynamic changes (blood pressure and pulse rate) and random blood sugar levels. The comparison is both within the group and between the two groups.

Healthy patients between the ages 20 and 60 years were included and randomized into two groups of 50 each. In one group, plain local anesthesia was used, whereas in the other group, local anesthetic solution containing adrenaline was used. Medically compromised patients were excluded from the study. Random blood sugar levels, blood pressures, and pulse rates were recorded in both groups before and 10 minutes after injecting the solutions. The findings were compared.

When results are compared within the group, a modest increase in the blood sugar level was noted with the group receiving local anesthetic with adrenaline. However, blood pressure and pulse rate showed no significant difference. Similarly, when between-the-groups comparison was done, not a single variable showed any significant difference.

The patients injected with local anesthesia containing adrenaline showed similar results to that observed in the patients injected with local anesthesia without adrenaline. However, there is a statistically significant rise in blood sugar levels when a local anesthetic is injected with adrenaline.

Dental extractions in healthy individuals can be safely performed with local anesthetic containing adrenaline. However, in diabetic patients, it should be cautiously used.

Byakodi S, Gurjar V, Soni S. Glucose Levels and Hemodynamic Changes in Patients submitted to Routine Dental Extraction under Local Anesthesia with and without Adrenaline. J Contemp Dent Pract 2017;18(1):57-59.

Bone removal is necessary for extracting the third molars that are erupted, partially erupted, and/or impacted in bone. Hence, it is necessary to choose a surgical method or instruments that conform to anatomic landmarks and are based on physiological principles. Many authors have reported injuries to the adjacent tooth, especially the distal part of periodontium after removal of second molar. Hence, the present study was undertaken to assess and compare the surgical and postsurgical outcomes of third molar removal using piezoelectric surgery and rotary bur.

A total of 30 healthy adult individuals who were in need of prophylactic removal of impacted mandibular third molar tooth with ideal condition were included for the study. Individuals were divided randomly into study groups of 15 each, so that the difficulty of surgery will be the same in both the groups. Group I – piezoelectric osteotomy technique and group II – rotary osteotomy technique. The rotary device consists of a hand piece and a rotary speed ranging around 35,000 rpm was used. The piezoelectric device consists of a hand piece, and a frequency of 25 to 29 kHz with a microvibration of 60 to 200 mm/sec was used with a boosted working mode. Data were analyzed using unpaired t-test and qualitative data were analyzed using Fischer's exact test.

The average age of the study subjects in the piezosurgery group and rotary group was 28.40 ± 2.69 and 30.06 ± 3.15 years respectively. The time taken for removal of impacted tooth by rotary bur was less than that by piezoelectric device, which was significant statistically (p < 0.05). Until the 4th postoperative day, severity of pain experienced was more in the rotary group, which was statistically significant (p < 0.005). Mouth opening was significantly better in the piezoelectric group as compared with rotary bur until the 7th postoperative day.

The piezosurgery method reduces postoperative pain, trismus, and swelling. Also, it may play an important role in increasing bone density within the extraction socket and decreasing the amount of bone loss of adjacent tooth in the distal aspect.

In clinical practice, piezosurgery plays an important role because piezosurgery reduces postoperative pain, trismus, and also swelling.

Basheer SA, Govind RJ, Daniel A, Sam G, Adarsh VJ, Rao A. Comparative Study of Piezoelectric and Rotary Osteotomy Technique for Third Molar Impaction. J Contemp Dent Pract 2017;18(1):60-64.

Malocclusions with anterior crossbite are a major esthetic and functional concern for patients. This case report presents a 27-year-old Syrian female who was diagnosed with a class 3 malocclusion, combined with anterior crossbite, deep bite, concave profile, and inadequate maxillary incisor exposure. There was a centric occlusion (CO)/centric relation (CR) discrepancy and the mandible could be manipulated to near edge-to-edge incisal relation.

Correction was done by class 3 intermaxillary elastics on upper and lower mini-implants for the first 6 months, followed by preadjusted edgewise appliance. The objective of implantsupported elastics was to adapt the patient for the CR condylar position without dental effect. Treatment was completed in 24 months with satisfactory dental and facial relationship.

Alhalabi AG, Mahaini S, Shebib G, Darwich K, Mahaini L. Nonsurgical Management of Adult Skeletal Class 3 with Deep Bite utilizing Mini-implants. J Contemp Dent Pract 2017;18(1):65-68.

Inverted tooth impaction is a rare occurrence. Third molar impaction is the most extensively studied, and only eight cases of inverted third molars have been reported in a literature search of 40 years from 1973 to 2013. In a study, 43.4% of the premaxillary supernumeraries were inverted and 21.1% were transversely oriented, while occasional inverted central incisors have been mentioned in the literature. Severe dilaceration makes the management of this case a big challenge. The case of an 8-year-old boy with an inverted, rotated, and impacted upper left central incisor obstructed by an odontome is presented here. Under local anesthesia, the odontome was excised; the inverted tooth was swung and repositioned. The patient experienced uneventful healing, and with 30 months follow-up, progressive tooth eruption has been observed. Vitality test is positive, while radiologically there was no sign of resorption. Swinging replantation is a protocol that has been used for the management of an inverted, rotated, and impacted central incisor. Open root apex is an important factor in the selection of the method. The minimal periodontal damage prevents inflammatory and replacement resorption. With some clear advantages over options like orthodontic and prosthetic replacement, it could be a method to be considered in the management of severely dilacerated central incisors.

The clinical significance is that even though management of a severely malpositioned tooth has always been a big challenge in dental practice, requiring extraction and prosthodontic replacement, swinging replantation provides a possible protocol of tooth retention, i.e., less expensive and associated with fewer hospital visits.

Bello SA, Enebong DJ, Obi EV. Swinging Replantation: A Possible Protocol for the Management of Inverted Impacted Upper Central Incisor Tooth. J Contemp Dent Pract 2017;18(1):69-73.

Microorganisms have been considered to have played a critical role in the initiation and development of pulpoperiapical diseases. Some evidences have shown that mechanical instrumentation may leave considerable portions of canal surfaces undebrided. Therefore, some supplemental methods, such as the use of chemical solutions and/or lasers, have been introduced to further disinfect the complicated canal anatomy and destroy as many microorganisms as possible. The purpose of this review was to address a brief review of characteristics of lasers and their effects to disinfect the root canal in endodontics.

Mohammadi Z, Jafarzadeh H, Shalavi S, Sahebalam R, Kinoshita JI. Laser-based Disinfection of the Root Canal System: An Update. J Contemp Dent Pract 2017;18(1):74-77.

Mandibular dislocation occurs when the condylar head glides out of the glenoid fossa with the condyle positioned in such a way that its posterior articulating surface lying ahead of the articular eminence. Recurrent mandibular dislocation is relatively uncommon. Patient is extremely distressed and goes through a lot of discomfort. Varied etiologies have been cited in the literature, such as keeping the mouth wide open for long periods of time during dental procedures, yawning, laughing, traumatic injuries to the mandible, psychiatric disturbances, and certain drugs. Acute dislocations are best managed immediately by reduction and intermaxillary fixation. However, dislocations that have remained over a period of a month are considered to be chronic and these cannot be reduced successfully by manual manipulation of the mandible.

Such chronic recurrent dislocations are surgically managed with eminectomy, meniscectomy, and condylotomies. A downward and forward osteotomy of the zygomatic arch in front of the articular eminence so as to produce a mechanical obstruction was recommended by Dautrey and Gosserez. This article will highlight the surgical experience of managing six patients with chronic recurrent dislocations of the temporomandibular joints (TMJs) bilaterally employing Dautrey's procedure.

Baptist J, Baliga M. Dautrey's Procedure Revisited in Management of Recurrent Mandibular Dislocation. J Contemp Dent Pract 2017;18(1):78-79.